| NPI | 1366592156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE OBERMAYR President 863-382-9947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN0011329) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |